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Dr. Kaushik, Psychiatrist

Category: Mental Health

Satisfied Customers: 4642

Experience: MD Psychiatry

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How do I overcome performance anxiety? I am 27yrs. old,

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How do I overcome sexual performance anxiety? I am 27yrs. old, male, and healthy other than high blood pressure, which is under control with Lisinopril which is not supposed to cause ED. My main problem is, I lose my erection just before I try penetration. I have no problems getting and maintaining an erection or climaxing during masturbation/foreplay/etc... but immediately before penetration, it just dies, completely or if I am lucky, only half way. I am in love with her, and know it's nothing to do with her. Even though I have become very comfortable with her, it seems I am locked in a vicious cycle of anxiety where I either consciously, or subconsciously think "Well, you failed last time, you will fail this time too!" I try SO hard to just relax, and stop worrying, and I am getting better, but I STILL can't penetrate her. How do I break free from this? How do I rid myself of anxiety? Do you suggest I temporarily try ED meds like viagra to get me thru this? It makes me so depressed!

Well, first of all let me clarify that ED is different from performance anxiety as ED can be due to medical as well as psychological causes including stress and Performance anxiety , BUT , you do not have ED , as you are able to get an erection , it is only when you get anxious and conscious about your performance during sexual intercourse that you loose an erection , so it is basically a psychological cause of Performance anxiety that is leading to all this , and it is certainly not ED.

So, i suggest that you get started on a mix of Drug therapy and psychotherapy ...

Psychotherapy that is counseling , you can seek from a psychologist who is well versed in Cognitive behavioural therapy ( CBT ) , which is a type of counseling technique which suits best for anxiety disorders like performance anxiety.

Secondly , along with CBT , you shall get 1 anti anxiety drug such as Buspar ( BUSPIRONE ) prescribed by your family doctor , and in advance i shall tell you that buspar unlike other anti anxiety drugs or anti depressant drugs does not have sexual side effects , and so is safe and very effective to be used to alleviate anxiety during performance.

So, a combination of CBT and Buspar will surely alleviate your performance anxiety , but this may take some time , say a month's time for full revival , but i believe the wait will be worth it.

Thanks for the answer, I will click the accept button for sure, but I have one more question. Do you think if I just went to my primary care doctor and explained my situation to her, that she would prescribe the Buspar without me seeing a psychologist first? The only reason I ask, is because I am not sure how much psychotherapy costs. I can certainly afford to see my primary care doctor, but I am not sure I can afford psychotherapy. I have no idea how expensive psychotherapy is, or if my insurance will pay for it. I just want to be prepared either way.I know my doctor was willing to prescribe me anti-anxiety drugs in the past, but that was several years ago. I think it was called Xanax or something like that, but that's probably a different drug than Buspar. Thanks again.

Well, yes your primary care doctor should be able to prescribe you buspar , if she would have prescribed xanax before , which again is an anti anxiety drug , but i would want you to try buspar first , as it is non benzodiazepine anti anxiety drug unlike xanax , which is non addictive and easy withdrawal can be achieved with it , unlike other anti anxiety drugs like xanax , however one flip side to its use is that it will take a around three weeks for it to reach its peak action and alleviate your performance anxiety which in comparison to xanax or ativan or klonopin ( all of these are benzodiazepine anti anxiety drugs , also used for performance anxiety , but to be left as a second option ) a bit longer tim e, but , safer and effective remedy.

So, no issues with the prescription of buspar from your primary care doctor .